Promotion and protection of breastfeeding: a key approach in the fight against malnutrition

Feed the children free from commercial pressure

Von Rosemarijn de Jong

Malnutrition is responsible for 3.5 million child deaths per year, according to the WHO. Suboptimal breastfeeding is estimated to be responsible for 1.4 million child deaths. Therefore, proper breastfeeding practices are one of the most important aspects in reducing child deaths and disease burden.

West Sumatra © Jefri Aries/IRIN

The WHO strongly recommends exclusive breastfeeding for the first six months of life. At six months, other foods should complement breastfeeding for up to two years or more.

Promotion and protection are two sides of improving breastfeeding practices, and both require equal attention for success. Protection includes among others the regulation of marketing of breast-milk substitutes (infant formula). To this use, the World Health Assembly adopted the International Code of Marketing of Breast-Milk Substitutes (BMS Code) in 1981. It stipulates that there should be absolutely no promotion of breast-milk substitutes, bottles and teats to the general public; that neither health facilities nor health professionals should have a role in promoting breast-milk substitutes; and that free samples should not be provided to pregnant women, new mothers or families.

Proofed violations of the BMS Code

In countries where laws around the BMS Code are weak, and surveillance is absent, manufacturers of infant formula often aggresively encourage mothers to stop breastfeeding their babies. Recently, local and international newspapers published proof of violations from various European/US manufacturers in Vietnam, among which the Dutch FrieslandCampina. An example was a women’s clinic where doctors were compensated for selling and promoting their products to pregnant women or new mothers.

Also in emergency situations, violations of the BMS Code are common. There are still numerous cases of relief agencies that donate infant formula on the assumption that mothers are not able to continue to breastfeed due to the stress. Besides violating the BMS Code, it has been proved to be detrimental to the health of children.

Right to choose

Wemos thinks that mothers have the right to choose how they feed their children, free from commercial pressure and fully informed about the health benefits of breastfeeding. Wemos is concerned that 30 years after the adoption of the International Code of Marketing of Breast-Milk Substitutes, manufacturers of infant formula still violate the BMS code so blatantly, despite ongoing efforts from organisations like IBFAN.

Both the EU and the Netherlands (here) and developing countries (there) must take responsibility for complying with the BMS Code. Responsibility there: policy, legislation and law enforcement in developing countries should be strenghtened. Responsibility here: the European Union, the Dutch government and by European manufacturers of infant formula should comply with international agreements.

*Rosemarijn de Jong was until January 2011 working for the dutch based Wemos Foundation as a project officer Nutrition. She has graduated in 2000 as a nutritionist from Wageningen University (The Netherlands). Since then she has gained broad experience in various sectors such as health education, communication and research. She has worked in Cameroon, Zambia and Vietnam. During her three years in Cameroon she worked in a local ngo on nutrition and health education to pregnant women and mothers of small children. Contact: